Provider Demographics
NPI:1073391405
Name:CONHEENEY, CAITLIN (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CONHEENEY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14404 KIRA LN
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-2664
Mailing Address - Country:US
Mailing Address - Phone:732-598-3156
Mailing Address - Fax:
Practice Address - Street 1:1493 E OLD SETTLERS BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2370
Practice Address - Country:US
Practice Address - Phone:512-399-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty